Ocular manifestations in SARS-CoV-2 positive patients: a systematic review

Objective: Investigate the importance of optical symptoms within SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) patients. Design: Systematic review Methods: Databases searched included Medline, EMBASE, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Clinicaltrials.gov, ProQuest. As well, meeting abstracts from American Academy of Ophthalmology, Association for Research in Vision and Ophthalmology and Canadian Ophthalmological Society were also considered. Articles underwent two rounds of screening before risk of bias assessment and data extraction. Results: In total, 582 studies were identified. A total of 2064 unique SARS-CoV-2 positive patients are included in this review from 13 different studies that met the inclusion criteria. We observed that the most common ocular symptoms in patients with SARS-CoV-2 were dry eyes, chemosis, epiphora, and blurred vision. The least common symptoms included hyperemia, conjunctivitis and photophobia. Additionally, we observed a unique relationship between patients with ocular manifestations and the severity of the systemic symptoms. Conclusion: Ocular symptoms do not occur commonly among SARS-CoV-2 positive patients; however, this study displays that there is an occurrence of common ocular manifestations such as dry eyes, chemosis, epiphora, and blurred vision. Therefore, increased ocular examinations may aid in diagnosis of SARS-CoV-2 infections.